Patient Access Representative III

Patient Access Representative

Be inspired. Be valued. Belong.

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

• Comprehensive health benefits that start day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family-focused benefits
• Wellness incentives
• Ongoing mentorship, development, leadership programs...and more

JOB DESCRIPTION:

• A Patient Access Representative will assist in the coordination, prioritization and completion of front-end patient registration activities ranging from pre-registration through discharge in the Patient Access Services Department.
• The representative will ensure patient insurance verification is accomplished and all requirements are met.
• Accurately completes patient registrations based on departmental protocols and standards, policies and procedures, and compliance with regulatory agencies.
• Calls patients to pre-register or confirm appointments.
• A Patient Access Representative prioritizes work for optimal reimbursement and to avoid financial risk to both patient and hospital.
• Ensures all insurance requirements are met prior to or on the date of service and informs patients of their financial liability and collects liability due.
• Identifies patients who require early financial counseling intervention.
• Ensures all uninsured patients are referred to a financial counselor as appropriate.
• A Patient Access Representative will also assist patients, guarantors and families with insurance questions in a professional manner and is responsible for escalating any unaddressed insurance benefit concerns to the department Financial Counselor.
• Maintains confidentiality of patient information, employee information and other information covered by regulations or professional ethics.
• Performs duties in support of the EHC Patient Access Mission Statement.
• Position requires self-motivated individual with demonstrated ability in time management who can handle high patient volumes and fast pace.
• Serves as point person for employee questions.
• Assists with departmental workflow as needed.
• The Patient Access Representative III must be able to work independently and be self-supervised.
• This position serves as a team lead, trainer and mentor to other team members.
• Management relies heavily on this position for their reporting of issues that should be escalated.
• Maintains thorough understanding of insurance, registration, scheduling, referrals, authorizations, and account follow-up.
• Maintains knowledge of multiple department system applications utilized by Patient Access Familiar with and adheres to all state and federal regulations such as EMTALA, CMS, HIPAA, and JCAHO guidelines Effectively communicates identified issues and concerns in a constructive and professional manner.
• Participates in generating ideas and solutions for improvements.
• Responds in a timely and appropriate way to verbal and written requests.
• Accurately searches the database to establish if patient is new or an established patient.
• Obtains required signature for release of information in a timely manner, adhering to policy and procedures.
• Completes registration by verification of information and insurance for established patient or entering information for new patient prior to discharge of patient.
• Reconfirms date of birth and legal spelling of the patients name.
• Obtains appropriate signature(s) and scans all appropriate documents (Admission/Registration Agreement, Notice of Privacy Practice, and Important Message from Medicare, etc.) Scans patient id and insurance cards.
• Makes every attempt to collect patient liability as appropriate and documents the response if not collected.
• Appropriately distributes registration paperwork according to departmental procedures.
• Schedules procedures/follow-up appointments.
• Communicates hospitals financial policies to all patients.
• Call patients to pre-register or confirm appointments.
• Maintains appropriate monthly assurance accuracy rate as determined by the department.
• Maintains established departmental standards regarding productivity, quality, and collections.
• Problem solving skills are required as the PAS Rep III must be able to use various tools, analyze the situation, and resolve and/or escalate accordingly.
• Assists in the training and onboarding of Patient Access staff.
• Provides continuity during the initial and ongoing training of employees throughout the onboarding process.

Minimum Qualifications:

• High school diploma or equivalent; associate or bachelor degree preferred.
• Working knowledge of Health Plan coverage types.
• 3 years experience in Patient Access or Revenue Cycle required CHAA or CPAR certification is preferred.
• Cross-trained in all areas of Patient Access specific to the entity.
• Assist with but not limited to special projects, preceptor/training, application testing, and report maintenance Current working knowledge of registration, insurance, and billing requirements is required.
• Knowledge of key terms such as: ABN, ICD, medical terminology, precertification, etc. required.
• Excellent interpersonal, verbal, and written communication skills and ability to speak and write effectively at a level appropriate for the job.
• Ability to work well with individuals at all levels of the organization.
• Experience using general office equipment.
• Proven ability to work in a fast-paced, demanding team environment with daily deadlines.

PHYSICAL REQUIREMENTS (Medium Max 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

Additional Details

Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare's Human Resources at View email address on click.appcast.io. Please note that one week's advance notice is preferred.